What is an aneurysm?
Aneurysms are enlarged blood vessels which continue to widen over time. They pose a risk to health because of their tendency to burst after they reach a certain size. The best way to treat them is to find them early, when they are small, and to time a curative procedure so that they are eliminated from the circulation before they rupture.
How do they occur?
Arteries carrying blood from the heart may become aneurysmal for a variety of reasons, but most aneurysms arise due to a combination of risk factors. These include age greater than 55, high blood pressure, family history and smoking. Men are affected six times more often than women. Some patients with aneurysms have no apparent risk factors at all, making prevention of this condition very difficult.
What are the symptoms?
The commonest aneurysm occurs in the aorta – the main artery which carries blood to the entire abdomen, pelvis and legs. Abdominal Aortic Aneurysms (AAA) generally do not cause symptoms until they rupture, or are very large. This absence of symptoms means that there is a significant risk of a patient with an aneurysm being discovered only after it has burst. Unfortunately this is a life-threatening scenario which requires emergency open surgery.
Many patients do not reach hospital owing to the seriousness of the bleeding which occurs. Other vessels are affected by aneurysms also and when these occur in the groin or leg arteries, they may cause symptoms of insufficient blood flow to the lower leg and foot. This can be very serious, so once again, a preventive procedure to eliminate such an aneurysm from the circulation, is the best treatment.
What happens if I’m screened and the result is positive?
The excellent news about screening is that a patient can have a curative procedure at the exact time when it will do the most good. A small aneurysm may take a few years to widen sufficiently to warrant treatment. Having an ultrasound examination every six months or so allows your doctor to get the timing just right. If treatment is required, this can take two forms. Massive advances in aneurysm treatment have occurred over the last ten years meaning that fewer and fewer patients with known aneurysms need to have ‘open’ aneurysm repair.
It is now possible to have an aneurysm treated through a 10cm incision on either side of the groin. General anaesthetic is often not required. Using this surgical access, a special graft can be advanced into the aneurysm and sealed internally inside it. Such treatment requires a hospital stay of a short number of days – and patients generally recover very quickly.